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Sometimes higher heart rate variability is not better heart rate variability: results of graphical and nonlinear analyses.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Sometimes higher heart rate variability is not better heart rate variability: results of graphical and nonlinear analyses. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Stein, PK, Domitrovich, PP, Hui, N, Rautaharju, P, Gottdiener, J |
| Journal | J Cardiovasc Electrophysiol |
| Volume | 16 |
| Issue | 9 |
| Pagination | 954-9 |
| Date Published | 2005 Sep |
| ISSN | 1045-3873 |
| Keywords | Aged, Aged, 80 and over, Algorithms, Arrhythmia, Sinus, Cohort Studies, Diagnosis, Computer-Assisted, Electrocardiography, Female, Heart Rate, Humans, Male, Models, Cardiovascular, Nonlinear Dynamics, Numerical Analysis, Computer-Assisted, Prevalence, Proportional Hazards Models, Reproducibility of Results, Risk Assessment, Risk Factors, Sensitivity and Specificity, United States |
| Abstract | <p><b>OBJECTIVE: </b>To determine the prevalence and effect on traditional heart rate variability (HRV) indices of abnormal HRV patterns in the elderly.</p><p><b>METHODS: </b>Hourly Poincaré plots and plots of spectral HRV from normal-to-normal interbeat intervals and hourly nonlinear HRV values were examined in a subset of 290 consecutive participants in the Cardiovascular Health Study. Only subjects in normal sinus rhythm with > or = 18 hours of usable data were included. Eligible subjects were 71 +/- 5 years. During 7 years of follow-up, 21.7% had died. Hours were scored as normal (0), borderline (0.5), or abnormal (1) from a combination of plot appearance and HRV. Summed scores were normalized to 100% to create an abnormality score (ABN). Short-term HRV versus each 5th percentile of ABN was plotted and a cutpoint for markedly increased HRV identified. The t-tests compared HRV for subjects above and below this cutpoint. Cox regression evaluated the association of ABN and mortality.</p><p><b>RESULTS: </b>Of 5,815 eligible hourly plots, 64.4% were normal, 14.5% borderline, and 21.1% abnormal. HR, SDNN, SDNNIDX, ln VLF and LF power, and power law slope did not differ by the cutpoint for increased short-term HRV, while SDANN and ln ULF power were significantly lower for those above the cutpoint. However, many HRV indices including LF/HF ratio and normalized LF and HF power were significantly different between groups (P < 0.001). Increased ABN was significantly associated with mortality (P = 0.019). Despite similar values for many HRV indices, being in the group above the cutpoint was significantly associated with mortality (P = 0.04).</p><p><b>CONCLUSIONS: </b>Abnormal HR patterns that elevate many HRV indices are prevalent among the elderly and associated with higher risk of mortality. Consideration of abnormal HRV may improve HRV-based risk stratification.</p> |
| DOI | 10.1111/j.1540-8167.2005.40788.x |
| Alternate Journal | J Cardiovasc Electrophysiol |
| PubMed ID | 16174015 |
| Grant List | N01-HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States R0-1 HL62181 / HL / NHLBI NIH HHS / United States |